Do you find yourself booking a doctor’s appointment the moment you notice a small ache?
Or do you do the exact opposite: avoiding the clinic for months because you are terrified of what a test might reveal?
If your relationship with medical care feels like an emotional rollercoaster, you aren’t alone.
According to Katarina Kikas, a researcher at the Black Dog Institute and UNSW Sydney, these reactions are part of a condition called Illness Anxiety Disorder (IAD).
Kikas and her team explored why people with health anxiety behave so differently when it comes to seeing a doctor.
By understanding the “why” behind these habits, you can begin to find a more balanced path to managing your health.
3 Types of Health Anxiety
The cycle of health anxiety isn’t just about worry; it’s a constant tug-of-war between the need for certainty and the fear of confirmation.
While we often think of health anxiety as “constantly going to the doctor,” the research shows it is much more complex.
Kikas explains that there are actually three main ways people respond to their fears:
- The Fluctuators: This is actually the most common group. These individuals bounce between seeking help and avoiding it depending on how they feel.
- The Care-Seekers: These individuals frequently look for medical tests or professional reassurance to calm their fears.
- The Care-Avoiders: These people tend to stay away from doctors and medical settings entirely.
Why Some People Constantly Seek Reassurance
For many, the doctor’s office feels like the only place to find safety.
According to the research, several internal drivers push people to book that next appointment:
- Obsessive Thoughts: When a health worry becomes a “stuck” thought at night, it often leads to a doctor’s visit the next day.
- Physical Sensations: Even a mild pain or a weird tingle can act as a “trigger” that motivates someone to seek care.
- Peace of Mind: Many seek care specifically for reassurance that they don’t have a serious illness.
- Family Motivation: Kikas found that some people seek help because they want to ensure they stay healthy enough to care for their children.
Why Others Avoid the Doctor Entirely
Avoidance isn’t about being lazy: it’s usually a survival tactic for a brain that feels overwhelmed.
Kikas and her team identified several reasons why someone might skip the clinic:
- Fear of the Worst Case: The most common reason for avoidance is the fear that a doctor will confirm your worst nightmare.
- Testing Anxiety: The wait for a test result or a scan can be so stressful that many people avoid the test altogether to skip the anxiety.
- Past Negative Experiences: If a doctor has dismissed your concerns or made you feel “silly” in the past, you are much less likely to go back.
- Practical Barriers: Factors like the high cost of care or a busy lifestyle also play a major role in staying away.
The “Fatigue” of Constant Worrying
If you find yourself switching between seeking help and avoiding it, you might be experiencing emotional fatigue.
The study found that seeking care can be so stressful and time-consuming that people eventually get “tired” of the cycle.
They might stop seeing doctors for months just to get a break.
However, as time passes, the worry that they might be “missing something serious” eventually builds back up, forcing them to return to the doctor.
Finding a Better Relationship with Your Health
Kikas suggests that the way doctors treat patients with health anxiety makes a huge difference.
Many people in the study felt invalidated or gaslighted when doctors told them they were just being a hypochondriac.
The research highlights that patients want to feel like a partner in their own care.
A doctor who listens and understands that health anxiety is a real struggle, not just all in your head, can help you break the cycle of seeking or avoiding.
Inevitable Outcome Trap
A novel and striking finding in this study was the concept of an inevitable negative outcome.
Some participants avoided care because they felt that “whatever happens, happens” and they had no control over the results.
They described a feeling that the writing’s on the wall, leading to a fatalistic avoidance of doctors.
This mindset is particularly damaging because it prevents the early detection of treatable conditions.
The research suggests that this specific cognitive bias, a feeling that a bad health outcome is “destined” to happen, may be unique to those with IAD.
By identifying this belief, therapists can now target this specific mental block to help patients re-engage with proactive health screenings.
WHAT THIS MEANS FOR YOU
The most empowering takeaway from this research is that your health behavior is not a fixed identity but a reaction to your environment and emotional energy.
The universal factor discovered is that Emotional Fatigue often dictates whether you seek or avoid care, meaning that managing your overall stress levels is just as vital as managing your specific health worries.
1. Identify the Leverage Point
- The Insight: Most people fluctuate because they reach a point of “emotional burnout” from too many appointments or too much searching.
- The Action: Start a “Worry Window” habit today. Instead of checking your symptoms or calling the doctor the moment an urge hits, schedule 15 minutes at 4:00 PM to evaluate the symptom. If it is not a medical emergency, wait for your window. This prevents the “cycle of fatigue” that leads to total avoidance later.
2. Optimize the “Environmental Engine”
- The Insight: Over 67% of people alternate their behavior based on perceived symptom severity, but often avoid the very tests that could save them out of fear.
- The Protocol: Create a “Neutral Decision Matrix.” Before a health concern arises, write down exactly what symptoms (e.g., a fever over 101°F or a persistent new lump) “qualify” for a doctor’s visit. By deciding while you are calm, you bypass the “fear of the answer” that usually stops you from going.
3. The “Social Intervention”
- The Insight: Feeling “dismissed” by a doctor is a primary reason for avoiding future care.
- The Action: Use the “Collaborative Script.” At your next appointment, say: “I am an expert on my body’s sensations, and I want to work with you as the expert on medical data. I sometimes struggle with health anxiety, so I would appreciate it if we could focus on the physical evidence and include me in the decision-making process”.
Your Personal Implementation Plan
The Conversation: Ask your doctor: “I’ve recently learned that my past experiences with being dismissed have made me avoidant. Can we establish a clear, data-driven plan for when I should come in and what tests are actually necessary so I don’t feel overwhelmed?”.
The Shift: Stop labeling yourself as a “hypochondriac” or a “procrastinator.” Instead, recognize that you are navigating a complex set of internal fears and external barriers.
Source
Kikas, K., Werner‐Seidler, A., Corkish, B., Upton, E., Holden, M., & Newby, J. M. (2026). Illness anxiety disorder: A qualitative study of people with health anxiety and their experiences seeking and avoiding medical care. British Journal of Clinical Psychology, 65(1), 68-85.
